Provider Demographics
NPI:1457500738
Name:WONG, JUDITH MING-HAI (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:MING-HAI
Last Name:WONG
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2888 LONG BEACH BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1570
Mailing Address - Country:US
Mailing Address - Phone:562-595-7696
Mailing Address - Fax:562-490-3846
Practice Address - Street 1:2888 LONG BEACH BLVD STE 240
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1570
Practice Address - Country:US
Practice Address - Phone:562-595-7696
Practice Address - Fax:562-490-3846
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130110207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery